NPI | 1255363503 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 44396) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 44396) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2012-06-05 |