NPI | 1891770756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 33939) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MN 48616) |
Enumeration Date | 2005-12-13 |
Last Update Date | 2007-07-08 |