NPI | 1760643811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: WI 69400) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2010020728) |
2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: MO 2010020728) | |
Enumeration Date | 2008-06-21 |
Last Update Date | 2018-07-10 |