NPI | 1285671529 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A96090) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX L7666) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2018-08-28 |