| NPI | 1164493250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME34114) |
| Additional Taxonomies | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: FL ME34114) |
| 208000000X Pediatrics (Licence: FL ME34114) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2010-07-27 |