NPI | 1073511507 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-19984) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0419984) |
208000000X Pediatrics (Licence: MO R3E01) | |
Enumeration Date | 2005-07-08 |
Last Update Date | 2012-05-31 |