NPI | 1487709044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: GA 053312) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D44535) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2007-07-08 |