| NPI | 1659389229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME88268) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME88268) |
| 207P00000X Emergency Medicine (Licence: FL me88268) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2022-03-04 |