NPI | 1336132224 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA G86401) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NV 11366) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 11366) | |
Enumeration Date | 2005-08-25 |
Last Update Date | 2018-08-02 |