NPI | 1356571731 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A119747) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125057064) |
Enumeration Date | 2009-07-21 |
Last Update Date | 2013-05-23 |