| NPI | 1740414002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 56199) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: SC 38200) |
| 208000000X Pediatrics (Licence: NC 2012-00845) | |
| 208000000X Pediatrics (Licence: SC 38200) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: SC 38200) | |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2024-04-10 |