NPI | 1205951720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2007-00739) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301083781) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301083781) | |
Enumeration Date | 2007-03-21 |
Last Update Date | 2007-10-11 |