NPI | 1619530532 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX V7998) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX V7998) |
Enumeration Date | 2019-04-16 |
Last Update Date | 2025-07-03 |