| NPI | 1619284189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME126494) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME126494) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2018-11-29 |