NPI | 1275710444 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: HI H2810) |
Additional Taxonomies | 261Q00000X Clinic/Center (Licence: HI H2810) |
Enumeration Date | 2008-01-30 |
Last Update Date | 2008-01-30 |