NPI | 1568849719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ND 71710) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 71710) |
Enumeration Date | 2015-04-27 |
Last Update Date | 2024-03-06 |