NPI | 1225092422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX L3062) |
Additional Taxonomies | 208000000X Pediatrics (Licence: GA 056750) |
Enumeration Date | 2006-04-14 |
Last Update Date | 2020-12-14 |