| NPI | 1356678395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 44554) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R70954) |
| 208000000X Pediatrics (Licence: AZ 44554) | |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2023-07-31 |