| NPI | 1255415709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 270364) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 232163) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NH 25681) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-08-07 |