| NPI | 1386606036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 13496) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 13496) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2012-12-05 |