NPI | 1972681948 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A33013) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A33013) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |