| NPI | 1144277047 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 26676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 26676) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2012-07-23 |