| NPI | 1821298779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME115551) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.30192) |
| 208000000X Pediatrics (Licence: AL MD.30192) | |
| 208000000X Pediatrics (Licence: SC LL29779) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2023-06-02 |