NPI | 1427540178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS21488) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS021622) |
Enumeration Date | 2018-05-30 |
Last Update Date | 2025-01-09 |