NPI | 1306823448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IA 27407) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NE 22112) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2012-09-17 |