NPI | 1700901337 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A85161) |
Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A85161) |
208D00000X General Practice (Licence: CA A85161) | |
Enumeration Date | 2007-03-20 |
Last Update Date | 2020-04-07 |