NPI | 1801964705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA G48168) |
Additional Taxonomies | 174400000X Specialist (Licence: CA G48168) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2009-12-18 |