| NPI | 1700847183 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 26612) | 
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 26612) | 
| Enumeration Date | 2006-03-28 | 
| Last Update Date | 2024-01-03 |