| NPI | 1003855339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: RI MD08011) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: RI MD08011) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2018-08-22 |