| NPI | 1629307756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A122169) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA a122169) |
| Enumeration Date | 2009-12-20 |
| Last Update Date | 2021-12-09 |