NPI | 1093392177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2021020364) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-10679) |
Enumeration Date | 2021-03-25 |
Last Update Date | 2021-06-27 |