| NPI | 1407883606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME142311) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 36794) |
| 208000000X Pediatrics (Licence: FL ME142311) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-04-20 |