| NPI | 1194898577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0057925) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD32886) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-01-26 |