| NPI | 1336679158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101268669) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: VA 0101268669) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-06-07 |