NPI | 1073003695 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OR MD223669) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0066577) |
Enumeration Date | 2018-05-18 |
Last Update Date | 2025-08-20 |