NPI | 1902035637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA A147108) |
Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD040411) |
Enumeration Date | 2009-07-01 |
Last Update Date | 2018-07-03 |