NPI | 1316339054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: HI 17994) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA 131115) |
Enumeration Date | 2015-03-03 |
Last Update Date | 2016-01-07 |