NPI | 1043836703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2023015522) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NE 8862) |
Enumeration Date | 2020-06-18 |
Last Update Date | 2024-08-13 |