| NPI | 1649561614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 53423) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CT 53423) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KS 05-48459) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2025-12-06 |