NPI | 1871757070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IL 125.054688) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WI 55876) |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 55876) | |
Enumeration Date | 2008-07-16 |
Last Update Date | 2021-07-30 |