NPI | 1760544118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: KS 0431279) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 0431279) |
Enumeration Date | 2006-12-14 |
Last Update Date | 2022-10-19 |