| NPI | 1831176171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 15906) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WV 15096) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2017-01-25 |