NPI | 1366424384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 155242) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 155242) |
2080H0002X (Licence: MA 155242) | |
Enumeration Date | 2005-11-16 |
Last Update Date | 2020-11-10 |