NPI | 1508510694 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2022023891) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KS 9411100) |
Enumeration Date | 2022-02-08 |
Last Update Date | 2022-08-03 |