| NPI | 1144227729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2018-00348) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD07109) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2018-05-16 |