NPI | 1881191989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2021029502) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2018019012) |
208000000X Pediatrics (Licence: KS 04-45128) | |
Enumeration Date | 2018-04-06 |
Last Update Date | 2021-09-14 |