NPI | 1912291402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 62044) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 62044) |
Enumeration Date | 2011-06-02 |
Last Update Date | 2020-04-16 |