| NPI | 1770697054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: FL ME58037) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: FL ME58037) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2018-05-21 |