NPI | 1750637906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0056804) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0056804) |
Enumeration Date | 2012-07-25 |
Last Update Date | 2024-09-30 |