NPI | 1891768180 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: KY 23025) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35051059) |
Enumeration Date | 2006-02-08 |
Last Update Date | 2007-07-08 |