| NPI | 1578538534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: MN 44939) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 44939) |
| 207P00000X Emergency Medicine (Licence: MN 44939) | |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: MN 44939) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-10-07 |