NPI | 1033613765 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A195452) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MDRE.ML.60865411) |
Enumeration Date | 2018-03-19 |
Last Update Date | 2024-08-21 |