| NPI | 1518157296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: AR E-14592) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA C154161) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OK 29043) | |
| 207P00000X Emergency Medicine (Licence: GA 64598) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2021-11-11 |