NPI | 1174547608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX K7930) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX K7930) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2012-06-12 |