NPI | 1427549187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD210274) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 275463) |
Enumeration Date | 2018-05-29 |
Last Update Date | 2023-11-22 |