| NPI | 1174663066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: VT 042.0014336) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CT 63616) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2025-02-11 |