| NPI | 1912007535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: SC 18709) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: SC 18709) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2023-03-07 |