| NPI | 1821292541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2010-00379) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2010-00379) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-12-18 |