NPI | 1700129715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.44922) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WV 27063) |
Enumeration Date | 2013-03-28 |
Last Update Date | 2024-05-09 |