NPI | 1295047850 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 263140) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 263140) |
Enumeration Date | 2010-07-11 |
Last Update Date | 2020-03-01 |