NPI | 1770500662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA MD.09485R) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA 09485R) |
208000000X Pediatrics (Licence: LA MD.09485R) | |
Enumeration Date | 2006-07-16 |
Last Update Date | 2013-04-26 |