NPI | 1487680211 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX U7312) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN MD0000030370) |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.065321) | |
Enumeration Date | 2006-06-23 |
Last Update Date | 2024-05-20 |