NPI | 1194743583 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2006-01045) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-080720) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2013-07-31 |