| NPI | 1558379578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.3765) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 3765) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-04-08 |