| NPI | 1235208679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX J9277) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01043128A) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2013-07-31 |