NPI | 1801355607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MS 30451) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL OS18983) |
Enumeration Date | 2019-03-19 |
Last Update Date | 2024-09-17 |