| NPI | 1548348774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME73671) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL me73671) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2018-06-13 |