NPI | 1639240062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0031385) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD23838) |
Enumeration Date | 2006-11-09 |
Last Update Date | 2017-02-17 |