NPI | 1275929143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX T9751) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 274880) |
208000000X Pediatrics (Licence: TX T9751) | |
Enumeration Date | 2015-04-08 |
Last Update Date | 2025-09-24 |