NPI | 1962778522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: VA 0101282300) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101282300) |
Enumeration Date | 2012-03-28 |
Last Update Date | 2024-07-10 |