NPI | 1740522937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX S6984) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2016011924) |
Enumeration Date | 2013-03-26 |
Last Update Date | 2020-11-30 |