| NPI | 1831478882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME122775) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301101722) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301101722) | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2015-04-01 |