| NPI | 1528046810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301096723) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 47665) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301096723) | |
| 208M00000X Hospitalist (Licence: MI 4301096723) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-12-03 |