NPI | 1255548277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 46480) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AZ 46480) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2015-02-23 |