NPI | 1659639292 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101257794) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN17001) |
Enumeration Date | 2012-05-02 |
Last Update Date | 2022-08-10 |