NPI | 1609372515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A175868) |
Additional Taxonomies | 208000000X Pediatrics (Licence: GA 89501) |
Enumeration Date | 2018-04-01 |
Last Update Date | 2024-10-25 |