NPI | 1154908630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 72289) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 31620) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 8360520) | |
Enumeration Date | 2021-03-29 |
Last Update Date | 2024-04-01 |