NPI | 1588125793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MD H96714) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD H96714) |
Enumeration Date | 2019-03-29 |
Last Update Date | 2024-10-24 |