| NPI | 1063530954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301085862) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MI 4301085862) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-11-06 |