NPI | 1265744718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ R71994) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A123121) |
Enumeration Date | 2010-07-12 |
Last Update Date | 2013-08-22 |