| NPI | 1619132073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME161426) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX T4899) |
| 208000000X Pediatrics (Licence: FL ME161426) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME161426) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 272450) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2024-05-23 |