| NPI | 1043691033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME158430) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME158430) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: IA MD-48563) | |
| 208000000X Pediatrics (Licence: IA MD-48563) | |
| 208000000X Pediatrics (Licence: MO 2015018256) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2023-03-30 |