| NPI | 1760453765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME83747) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME83747) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2007-08-24 |