NPI | 1730400821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NY 390200000x) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA10588300) |
Enumeration Date | 2010-06-13 |
Last Update Date | 2020-12-07 |