NPI | 1144298993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 29376) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 29376) |
Enumeration Date | 2006-03-09 |
Last Update Date | 2024-01-05 |