NPI | 1811961154 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0102203160) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WV 1878) |
Enumeration Date | 2006-02-14 |
Last Update Date | 2013-07-10 |