NPI | 1093133621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME130421) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME130421) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2019-05-23 |