NPI | 1952337552 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AL 12739) |
Additional Taxonomies | 2080A0000X Pediatrics Adolescent Medicine (Licence: AL 12739) |
Enumeration Date | 2006-06-24 |
Last Update Date | 2010-10-28 |