NPI | 1730376518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD60216901) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KS 04-47989) |
Enumeration Date | 2007-09-26 |
Last Update Date | 2023-09-22 |