| NPI | 1699844324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MA 230553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 230553) |
| 208000000X Pediatrics (Licence: MA 230553) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2021-09-07 |