| NPI | 1962686089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2009-00383) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2009-00383) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2022-11-02 |