NPI | 1235115908 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 34744) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A80164) |
Enumeration Date | 2005-12-15 |
Last Update Date | 2019-04-22 |