NPI | 1750358370 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0039342) |
Additional Taxonomies | 174400000X Specialist (Licence: MD D0039342) |
Enumeration Date | 2006-03-02 |
Last Update Date | 2019-04-01 |