| NPI | 1164861001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME0120567) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: FL ME0120567) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2017-03-28 |