| NPI | 1356963466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0101280894) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101280894) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2024-06-11 |