NPI | 1710955240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 46053) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 142390) |
Enumeration Date | 2006-03-10 |
Last Update Date | 2010-04-22 |