NPI | 1588654602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 37840) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MA 37840) |
Enumeration Date | 2005-10-28 |
Last Update Date | 2007-07-08 |