NPI | 1801325261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 306541) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT212912) |
Enumeration Date | 2017-06-08 |
Last Update Date | 2023-05-11 |