NPI | 1578564928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 9801433) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 98-01433) |
Enumeration Date | 2005-08-09 |
Last Update Date | 2023-03-07 |