NPI | 1851588644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: ID M-8153) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101264959) |
208000000X Pediatrics (Licence: UT 5053872-1205) | |
Enumeration Date | 2007-09-26 |
Last Update Date | 2022-01-12 |