| NPI | 1912313149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MI 4301111676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301111676) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2024-08-05 |