NPI | 1174745061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX M7374) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2007-05-02 |
Last Update Date | 2008-12-10 |