NPI | 1528447752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD466575) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 292601) |
Enumeration Date | 2015-05-20 |
Last Update Date | 2020-08-27 |