NPI | 1932312568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.29029) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.010550) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2008-07-29 |