| NPI | 1619009214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: FL ME 128390) |
| Additional Taxonomies | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: CA A91278) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2016-07-07 |