| NPI | 1568413094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: SC 31651) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00026387) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-11-13 |