| NPI | 1962778522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: VA 0101282300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101282300) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2024-07-10 |