NPI | 1043672835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME146697) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A161617) |
Enumeration Date | 2016-03-22 |
Last Update Date | 2022-10-29 |