| NPI | 1295912764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME126811) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2009010647) |
| 208000000X Pediatrics (Licence: MO 2009010647) | |
| 208000000X Pediatrics (Licence: FL ME126811) | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2016-06-27 |