NPI | 1851367411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0063929) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 141212-1) |
Enumeration Date | 2006-02-24 |
Last Update Date | 2015-12-17 |