NPI | 1831657733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101270432) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101270432) |
Enumeration Date | 2019-03-10 |
Last Update Date | 2023-08-08 |