| NPI | 1659531374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301092261) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301092261) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2016-12-06 |