NPI | 1962607911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: UT 7569499-1205) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 50866) |
Enumeration Date | 2007-06-19 |
Last Update Date | 2021-12-14 |