NPI | 1174571632 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 24487) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MO 2005024068) |
Enumeration Date | 2006-05-05 |
Last Update Date | 2022-08-11 |