| NPI | 1649597279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CT 56197) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 56197) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2022-07-21 |