NPI | 1033422571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 51791) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PR 18622) |
Enumeration Date | 2010-07-26 |
Last Update Date | 2019-08-23 |