| NPI | 1629118518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA G88903) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 6624) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-09-13 |