| NPI | 1922494913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA A130065) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A130065) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2024-10-15 |