| NPI | 1780113837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 14266) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 51228) |
| Enumeration Date | 2017-06-11 |
| Last Update Date | 2023-08-01 |