NPI | 1154497360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA G30755) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 13259) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2007-07-08 |