| NPI | 1194716837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD09348) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD 9348) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-09-30 |