NPI | 1548251952 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NY 170483) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX N4673) |
Enumeration Date | 2005-11-03 |
Last Update Date | 2024-04-05 |