NPI | 1184609943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ A54894) |
Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A54894) |
Enumeration Date | 2005-12-14 |
Last Update Date | 2025-06-24 |