NPI | 1487215398 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA 346409) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301506598) |
Enumeration Date | 2019-06-23 |
Last Update Date | 2025-06-11 |