NPI | 1932361078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX P7550) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 249270) |
Enumeration Date | 2008-06-30 |
Last Update Date | 2018-03-20 |