NPI | 1053793836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0060771) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NE 7589) |
Enumeration Date | 2015-06-29 |
Last Update Date | 2024-11-15 |