NPI | 1730685629 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1020043) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 1020043) |
Enumeration Date | 2018-04-01 |
Last Update Date | 2024-06-04 |