NPI | 1760790448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS15375) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102203309) |
Enumeration Date | 2010-09-16 |
Last Update Date | 2018-09-07 |