NPI | 1326018912 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL 40932) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2018-01802) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2023-02-07 |