NPI | 1508421512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2022-01704) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL82175) |
Enumeration Date | 2019-05-06 |
Last Update Date | 2022-07-21 |