NPI | 1689092264 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61121460) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD182163) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2024-06-13 |