| NPI | 1275576266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 81647) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 81647) |
| 2083T0002X Preventive Medicine, Medical Toxicology (Licence: MA 81647) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-08-14 |