NPI | 1427136233 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA G36418) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA G36418) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2008-03-26 |