| NPI | 1518975002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME84811) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME0084811) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME84811) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-03-07 |