NPI | 1982792396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME170534) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A78371) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2025-03-04 |