| NPI | 1366479040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 43010161508) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 43010161508) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2008-03-14 |