| NPI | 1689632739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME125826) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 236034) |
| 208000000X Pediatrics (Licence: LA MD.203274) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA MD.203274) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 236034) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2024-02-08 |