NPI | 1306106380 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 270125) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A135188) |
Enumeration Date | 2012-05-23 |
Last Update Date | 2022-06-06 |