| NPI | 1235209172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0033331) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 22082-020) |
| 208000000X Pediatrics (Licence: DC MD18708) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-11-30 |