| NPI | 1053460352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 32595-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 32595) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2011-04-13 |