| NPI | 1396011540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MA 291313) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: IL 036.146188) |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2023-04-03 |