| NPI | 1053348508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD41181) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD41181) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2010-05-24 |