NPI | 1811152044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2011012289) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 20080117891) |
Enumeration Date | 2008-07-28 |
Last Update Date | 2011-08-05 |