NPI | 1922549187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.138672) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OK 35.138672) |
Enumeration Date | 2017-03-20 |
Last Update Date | 2020-06-03 |