NPI | 1477767473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD436510) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.011699) |
Enumeration Date | 2007-05-09 |
Last Update Date | 2025-02-03 |