NPI | 1194798777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301080025) |
Additional Taxonomies | 174400000X Specialist (Licence: MI 4301080025) |
Enumeration Date | 2006-02-13 |
Last Update Date | 2023-03-07 |