| NPI | 1548268634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 038803) |
| Additional Taxonomies | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: CT 038803) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2007-07-08 |