NPI | 1255771671 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD181386) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2013020099) |
Enumeration Date | 2013-06-29 |
Last Update Date | 2022-07-21 |