| NPI | 1235287731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS10683) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL UO1487) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-04-21 |