| NPI | 1366482275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: DC MD036806) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101238650) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2023-01-30 |