| NPI | 1629064134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS008325L) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL OS15663) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2025-05-06 |