| NPI | 1225062516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 23479) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 41127) |
| 208000000X Pediatrics (Licence: IL 036.119839) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2012-07-12 |