NPI | 1548284680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: DE C1-0006030) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD-071360-L) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2007-07-08 |