NPI | 1386676351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: PA md043162E) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD043162E) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2018-11-06 |