NPI | 1528150356 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: SC 35072) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200300755) |
208000000X Pediatrics (Licence: MD D65480) | |
Enumeration Date | 2006-09-29 |
Last Update Date | 2020-10-08 |