| NPI | 1447203179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 46683) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 46683) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2018-04-25 |