| NPI | 1528105194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OR MD214291) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 294757-1) |
| 208000000X Pediatrics (Licence: OR MD214291) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KY 40990) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 294757-1) | |
| 207R00000X Internal Medicine (Licence: OR MD214291) | |
| 208000000X Pediatrics (Licence: KY 40990) | |
| 207R00000X Internal Medicine (Licence: KY 40990) | |
| 207R00000X Internal Medicine (Licence: NY 294757-1) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2023-03-15 |