| NPI | 1609803030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: MD D63782) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MD D63782) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2024-02-28 |