NPI | 1780142216 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35145338) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35145338) |
Enumeration Date | 2019-03-04 |
Last Update Date | 2022-05-26 |