NPI | 1568428316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OH 35.045009) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.045009) |
Enumeration Date | 2006-04-21 |
Last Update Date | 2024-04-24 |