NPI | 1306075395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2011-0531) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A108100) |
Enumeration Date | 2009-07-10 |
Last Update Date | 2012-01-26 |