NPI | 1215316294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 287364) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301114195) |
Enumeration Date | 2015-05-25 |
Last Update Date | 2023-06-28 |