| NPI | 1417901430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN MD0000041162) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 42884) |
| 207P00000X Emergency Medicine (Licence: TN 41162) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2015-08-13 |