NPI | 1891729547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 251662) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 227899) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2015-05-05 |