NPI | 1649350919 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 50967) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA G50967) |
208000000X Pediatrics (Licence: NC 0000-34906) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2020-10-02 |