NPI | 1629064134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 070804) |
Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 15263R) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA MD.15263R) | |
Enumeration Date | 2005-09-21 |
Last Update Date | 2014-01-13 |