NPI | 1215932850 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AZ 23562) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 23562) |
Enumeration Date | 2005-06-20 |
Last Update Date | 2025-09-11 |