NPI | 1013137694 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME0111708) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-6152) |
Enumeration Date | 2007-04-26 |
Last Update Date | 2016-04-28 |