| NPI | 1750485124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MN 48499) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 48499) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MN 48499) | |
| 208000000X Pediatrics (Licence: MN 48499) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2009-07-10 |