NPI | 1497730774 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CO 0060438) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TN 36948) |
Enumeration Date | 2005-12-09 |
Last Update Date | 2025-02-26 |