NPI | 1801355607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 99101) |
Additional Taxonomies | 208000000X Pediatrics (Licence: GA 99101) |
208000000X Pediatrics (Licence: FL OS18983) | |
208000000X Pediatrics (Licence: MS 30451) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2025-06-06 |