NPI | 1649699240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: GA 85565) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 85565) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2023-11-27 |