NPI | 1699411074 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 011770) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 011770) |
Enumeration Date | 2022-05-09 |
Last Update Date | 2025-09-24 |