NPI | 1801182860 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A124240) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MS 23936) |
208000000X Pediatrics (Licence: GA 4803) | |
Enumeration Date | 2011-06-28 |
Last Update Date | 2024-10-28 |