NPI | 1154853851 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D89366) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 1019279) |
2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 1019279) | |
Enumeration Date | 2017-03-31 |
Last Update Date | 2024-06-26 |