NPI | 1518426980 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 92047) |
Additional Taxonomies | 208000000X Pediatrics (Licence: GA 92047) |
Enumeration Date | 2019-03-15 |
Last Update Date | 2025-06-06 |