| NPI | 1598713976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME78113) |
| Additional Taxonomies | 174400000X Specialist |
| 207P00000X Emergency Medicine (Licence: FL ME78113) | |
| 208000000X Pediatrics (Licence: FL ME78113) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2018-06-13 |