| NPI | 1457394736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 29085) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD29085) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TN MD29085) | |
| 207P00000X Emergency Medicine (Licence: TN 29085) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2015-07-10 |