NPI | 1801843297 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX 2663) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NJ 25MA0066859) |
Enumeration Date | 2006-05-30 |
Last Update Date | 2024-04-15 |