NPI | 1972562551 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PR 11181) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PR 11181) |
Enumeration Date | 2006-03-21 |
Last Update Date | 2007-07-08 |