| NPI | 1407017312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TN 47183) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TN MD47183) |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: TN MD47183) | |
| 208000000X Pediatrics (Licence: TN 47183) | |
| 208000000X Pediatrics (Licence: OH 35 . 089787) | |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: OH 35. 089787) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2022-03-16 |