NPI | 1275730236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60217580) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT190264) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2012-01-24 |