| NPI | 1528143567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301069518) |
| Additional Taxonomies | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: MI 4301069518) |
| 208000000X Pediatrics (Licence: MI 4301069518) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2021-11-04 |