| NPI | 1265522361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL me0069157) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL me0069157) |
| 207R00000X Internal Medicine (Licence: FL me0069157) | |
| 208000000X Pediatrics (Licence: FL me0069157) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2025-09-11 |