NPI | 1982938700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: ID M-12467) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD 60174015) |
Enumeration Date | 2009-09-25 |
Last Update Date | 2016-03-28 |