NPI | 1154908630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WI 83605-20) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 72289) |
208000000X Pediatrics (Licence: MN 31620) | |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 8360520) | |
Enumeration Date | 2021-03-29 |
Last Update Date | 2025-09-09 |