| NPI | 1932293511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2006-00154) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2006-00154) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-01-19 |