NPI | 1639138332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PR 11676) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PR 11676) |
Enumeration Date | 2006-03-21 |
Last Update Date | 2016-11-16 |