NPI | 1952388357 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX H8233) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR. 0054363) |
Enumeration Date | 2005-12-28 |
Last Update Date | 2014-10-26 |