NPI | 1497781561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A91416) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME130710) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2021-11-29 |