NPI | 1649413824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 95129) |
Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 0000048757) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX Q6186) | |
Enumeration Date | 2009-04-17 |
Last Update Date | 2025-02-26 |