NPI | 1750885752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 315381) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS021250) |
208000000X Pediatrics (Licence: NY 315381) | |
Enumeration Date | 2018-03-23 |
Last Update Date | 2023-08-02 |