NPI | 1841293164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX K6254) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX K6254) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 51588) | |
Enumeration Date | 2005-05-31 |
Last Update Date | 2023-09-29 |