NPI | 1306965579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX M7900) |
Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX M7900) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2025-07-15 |