| NPI | 1699970830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NV 16455) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 40833) |
| 207P00000X Emergency Medicine (Licence: VT 042.0012577) | |
| 207P00000X Emergency Medicine (Licence: CO 48971) | |
| 207P00000X Emergency Medicine (Licence: NM MD2015-0100) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NE 27906) | |
| 208000000X Pediatrics (Licence: CO 0048971) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2024-01-31 |