NPI | 1629480173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: LA 322365) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA 322365) |
Enumeration Date | 2014-06-02 |
Last Update Date | 2020-08-19 |