NPI | 1225133556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA G77588) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00045952) |
Enumeration Date | 2006-09-13 |
Last Update Date | 2020-03-11 |