| NPI | 1912084260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD00036615) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: WA MD00036615) |
| 208000000X Pediatrics (Licence: WA MD00036615) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-02-02 |