NPI | 1851473078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: PR 4917) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: PR 4917) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2007-07-08 |