NPI | 1811378383 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: IA DO-05245) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-10366) |
Enumeration Date | 2015-06-10 |
Last Update Date | 2018-11-02 |