| NPI | 1588009633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD458817) | 
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PA MD458817) | 
| 208000000X Pediatrics (Licence: PA MD458817) | |
| Enumeration Date | 2013-05-02 | 
| Last Update Date | 2024-05-22 |