| NPI | 1033354493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2011020657) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0435217) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2011-09-09 |