| NPI | 1447280680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GU M-1605) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 37917) |
| 207P00000X Emergency Medicine (Licence: CA C53333) | |
| 207P00000X Emergency Medicine (Licence: AZ 40092) | |
| 208000000X Pediatrics (Licence: FL ME0065167) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2009-11-04 |