| NPI | 1952818536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA A149353) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A149353) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2023-08-17 |