NPI | 1023228277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KY 44395) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 44395) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2014-09-04 |