NPI | 1649526765 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A119549) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35. 099330) |
Enumeration Date | 2012-07-26 |
Last Update Date | 2013-03-06 |