| NPI | 1730462771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.131918) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2015002876) |
| 208000000X Pediatrics (Licence: TX P4466) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX P4466) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2015002876) | |
| 208000000X Pediatrics (Licence: NJ 25MA10561800) | |
| 207P00000X Emergency Medicine (Licence: TN 55347) | |
| 207P00000X Emergency Medicine (Licence: TX P4466) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA10561800) | |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2024-06-28 |