NPI | 1164508479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SC MMD.34396 MD) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN10113) |
208000000X Pediatrics (Licence: SC 34396) | |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 62846) | |
Enumeration Date | 2006-10-29 |
Last Update Date | 2023-06-28 |