| NPI | 1912427402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 5101025654) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MI 5101025654) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2023-08-30 |