NPI | 1518980267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 38828) |
Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 38828) |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MN 38828) | |
Enumeration Date | 2006-07-25 |
Last Update Date | 2021-11-08 |