NPI | 1821004292 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD065530L) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD065530L) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2013-04-16 |