| NPI | 1356329056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME0057642) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME0057642) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2015-06-23 |