| NPI | 1386610210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: GA 054482) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 054482) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 054482) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2022-08-12 |