NPI | 1629432687 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD480743) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME141032) |
Enumeration Date | 2016-04-06 |
Last Update Date | 2023-08-30 |