| NPI | 1477715381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME 102464) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 249355) |
| 207P00000X Emergency Medicine (Licence: NY 249355) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2024-05-30 |