| NPI | 1669559233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 12190) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME111957) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: SD 12190) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-05-12 |