NPI | 1376885020 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD482048) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.125119) |
Enumeration Date | 2013-03-20 |
Last Update Date | 2023-08-14 |