| NPI | 1427058114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0101250341) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101250341) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 31432) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2019-10-16 |