NPI | 1033254396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: DE C10008229) |
Additional Taxonomies | 208D00000X General Practice (Licence: DE C10008229) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2016-01-12 |