NPI | 1194929752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CO 51278) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0023109) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2021-05-04 |