NPI | 1114984564 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX K0574) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TX K0574) |
Enumeration Date | 2006-04-28 |
Last Update Date | 2021-04-22 |