NPI | 1558748988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX V5514) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NE 30670) |
Enumeration Date | 2015-05-06 |
Last Update Date | 2025-02-19 |