| NPI | 1366603235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: SC 31019) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2011-00547) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2021-10-19 |