NPI | 1104142371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX P6899) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10036643) |
Enumeration Date | 2010-04-13 |
Last Update Date | 2022-11-07 |