| NPI | 1427402106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME157014) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME157014) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OK 34757) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2023-09-26 |