NPI | 1295475218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: UT 13521412-1205) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 13521412-1205) |
Enumeration Date | 2022-03-29 |
Last Update Date | 2023-08-09 |