NPI | 1356684138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MD D89054) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 283808-01) |
Enumeration Date | 2013-03-31 |
Last Update Date | 2021-01-02 |