NPI | 1699271460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX T1019) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-160685) |
Enumeration Date | 2018-04-02 |
Last Update Date | 2023-11-08 |