NPI | 1043012362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2025018757) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-12394) |
Enumeration Date | 2025-03-26 |
Last Update Date | 2025-06-17 |