| NPI | 1013993831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL me78049) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL 78049) |
| 208000000X Pediatrics (Licence: FL ME78049) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL 78049) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2024-07-17 |