NPI | 1609088350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A9172) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A 9172) |
Enumeration Date | 2007-05-04 |
Last Update Date | 2023-11-10 |