NPI | 1225061104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX K5093) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX k5903) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2024-06-02 |