NPI | 1710950548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2010-01364) |
Additional Taxonomies | 174400000X Specialist (Licence: KY 39507) |
Enumeration Date | 2006-02-10 |
Last Update Date | 2010-10-14 |