NPI | 1972595957 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: CA A74018) |
Additional Taxonomies | 173000000X Legal Medicine |
Enumeration Date | 2005-08-17 |
Last Update Date | 2023-02-28 |