NPI | 1669521332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00026233) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01034261A) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2007-07-08 |