NPI | 1215906607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NC 2008-00312) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0060461) |
Enumeration Date | 2006-03-16 |
Last Update Date | 2009-01-22 |