NPI | 1619157047 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A95477) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A95477) |
Enumeration Date | 2007-11-14 |
Last Update Date | 2021-10-25 |