NPI | 1659831436 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1022342) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT224867) |
Enumeration Date | 2019-03-20 |
Last Update Date | 2025-05-13 |