NPI | 1386705721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101057696) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D61216) |
208000000X Pediatrics (Licence: DC MD034757) | |
Enumeration Date | 2006-12-12 |
Last Update Date | 2021-06-23 |