| NPI | 1568480796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine Pediatric Emergency Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 2085U0001X Radiology Diagnostic Ultrasound | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-12-06 |