NPI | 1912998352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35069494) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35069494p) |
Enumeration Date | 2005-11-03 |
Last Update Date | 2022-02-12 |