NPI | 1760910251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 335886) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 65795) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 73004) | |
Enumeration Date | 2017-05-26 |
Last Update Date | 2023-07-19 |