NPI | 1700144649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2014-00986) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC MMD.23462) |
208000000X Pediatrics (Licence: TX U0618) | |
208000000X Pediatrics (Licence: AZ 67907) | |
Enumeration Date | 2012-04-29 |
Last Update Date | 2023-04-16 |