| NPI | 1912223215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD158374) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD158374) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OR MD158374) | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2016-06-20 |