| NPI | 1477666030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A8709) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL OS9838) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA 8709) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2015-07-23 |