| NPI | 1043665813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL OS16105) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS16105) |
| 208000000X Pediatrics (Licence: FL OS16105) | |
| 208M00000X Hospitalist (Licence: FL OS16105) | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2024-03-08 |