| NPI | 1326332545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NV DO2278) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV DO2278) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: NV DO2278) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2024-01-25 |