NPI | 1093784241 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WI 31269) |
Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: WI 31269) |
Enumeration Date | 2006-03-17 |
Last Update Date | 2021-01-11 |