NPI | 1689608655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A062992) |
Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: CA A062992) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2007-07-08 |