NPI | 1396835047 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: NY 232607) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 232607) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2013-05-20 |