| NPI | 1528420361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: CO 0068496) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 59448) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TN 59448) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-06-13 |