| NPI | 1982682761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2001017150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2001017150) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KS 05-31670) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2011-06-13 |