| NPI | 1326102930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD29912) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD29912) |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: TN MD29912) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2023-03-07 |