NPI | 1356432652 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: NY 229933) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 229933-1) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2023-03-07 |