NPI | 1871817502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2016011309) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2016011309) |
Enumeration Date | 2010-03-24 |
Last Update Date | 2021-01-15 |