NPI | 1821177833 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A49168) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A49168) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2012-01-24 |