| NPI | 1235180852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MA 1024725) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: RI MD14967) |
| 208000000X Pediatrics (Licence: RI MD14967) | |
| 208000000X Pediatrics (Licence: CT 043923) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: RI MD14967) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2025-09-11 |