NPI | 1649677014 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP60919974) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID O-1797) |
208000000X Pediatrics (Licence: CA 20A13699) | |
Enumeration Date | 2014-12-01 |
Last Update Date | 2023-05-17 |