NPI | 1063501591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301056997) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301056997) |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MI 4301056997) | |
Enumeration Date | 2006-10-12 |
Last Update Date | 2018-03-17 |