NPI | 1285738757 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WI 32036) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-092497) |
Enumeration Date | 2006-09-12 |
Last Update Date | 2020-12-23 |