| NPI | 1528029352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 21344) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 21344) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2008-02-19 |