| NPI | 1487000238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301116931) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301116931) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2022-06-14 |