| NPI | 1205018546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME169570) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301088989) |
| 208000000X Pediatrics (Licence: OH 35099973) | |
| 208000000X Pediatrics (Licence: FL ME169570) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35099973) | |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2024-08-19 |