| NPI | 1215923362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 215862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 215862) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2024-02-28 |