NPI | 1508973603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WI 45299) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-102772) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2019-02-21 |