NPI | 1275761371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA 129572) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2012-01200) |
Enumeration Date | 2009-06-26 |
Last Update Date | 2023-11-22 |