NPI | 1679567085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD12816) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD121816) |
Enumeration Date | 2005-08-31 |
Last Update Date | 2008-04-23 |