NPI | 1366691115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA A149736) |
Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD040595) |
Enumeration Date | 2008-09-17 |
Last Update Date | 2022-07-21 |