| NPI | 1447871710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2023-01496) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2023-01496) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NC 2023-01496) | |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2024-07-15 |