| NPI | 1972767648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R70601) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R70601) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2011-02-25 |