NPI | 1497902225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A111033) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.010311) |
Enumeration Date | 2008-08-22 |
Last Update Date | 2021-11-23 |