| NPI | 1871798553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD60448459) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 55563020) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: WA MD60448459) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2014-06-18 |