NPI | 1699715888 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WI 69544-20) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-104343) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2019-02-01 |