| NPI | 1508803073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME123048) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME123048) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME123048) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2024-05-23 |