NPI | 1689937849 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME110294) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME110294) |
Enumeration Date | 2012-06-21 |
Last Update Date | 2015-06-18 |