NPI | 1477058725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-44521) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2021013948) |
Enumeration Date | 2018-03-28 |
Last Update Date | 2021-06-23 |