NPI | 1649546185 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.125871) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.125871) |
Enumeration Date | 2012-03-29 |
Last Update Date | 2019-06-06 |