| NPI | 1417235599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R72885) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R72885) |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2011-07-24 |