| NPI | 1083658686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MA 208732) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 208732) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-07-18 |