NPI | 1720066061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A61200) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IA 33426) |
208000000X Pediatrics (Licence: HI 9078) | |
Enumeration Date | 2006-01-06 |
Last Update Date | 2025-01-30 |