NPI | 1023270238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 262506) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 262506) |
207L00000X Anesthesiology (Licence: MA 262506) | |
208000000X Pediatrics (Licence: MA 262506) | |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A116860) | |
Enumeration Date | 2008-06-29 |
Last Update Date | 2019-08-15 |