| NPI | 1346507076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NV 17761) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 53286) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NV 17761) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 53286) | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2018-06-27 |