| NPI | 1841268786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME152197) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD425070) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PA MD425070) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MO 2007035058) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2021-08-05 |