| NPI | 1851710214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA 332699) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60941727) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-06-14 |