| NPI | 1861811945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME145254) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.130870) |
| 208000000X Pediatrics (Licence: OH 35.130870) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-02-02 |