NPI | 1972703213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2022045451) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A109516) |
Enumeration Date | 2007-07-24 |
Last Update Date | 2022-11-28 |