NPI | 1376925545 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 311048) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT209804) |
208000000X Pediatrics (Licence: CT 61442) | |
Enumeration Date | 2015-06-24 |
Last Update Date | 2021-07-13 |