NPI | 1376084707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301511122) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.152249) |
Enumeration Date | 2017-03-18 |
Last Update Date | 2024-04-01 |