NPI | 1134864564 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NV SL1993) |
Additional Taxonomies | 208600000X Surgery (Licence: OH 58.032971) |
Enumeration Date | 2022-04-29 |
Last Update Date | 2023-06-19 |