| NPI | 1013949726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD035621) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ MA77519) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-16 |