| NPI | 1356473870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2008-00114) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2008-00114) |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2023-12-18 |