NPI | 1306852934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA C141296) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301076933) |
208000000X Pediatrics (Licence: IN 01071369A) | |
Enumeration Date | 2006-08-01 |
Last Update Date | 2022-05-24 |