NPI | 1174905269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME162355) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME162355) |
Enumeration Date | 2015-06-24 |
Last Update Date | 2023-09-18 |