NPI | 1689863649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX P4118) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD27655) |
Enumeration Date | 2007-10-16 |
Last Update Date | 2019-05-06 |