NPI | 1629005582 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NY 137172) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 137172) |
Enumeration Date | 2006-06-27 |
Last Update Date | 2023-06-13 |