NPI | 1306223730 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A153424) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301108055) |
Enumeration Date | 2015-05-06 |
Last Update Date | 2018-09-26 |