| NPI | 1497804603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NC 2010-00914) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2010-00914) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-04-06 |