NPI | 1841826823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0102206921) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102206921) |
Enumeration Date | 2020-03-21 |
Last Update Date | 2023-10-25 |