| NPI | 1275667347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 56387) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D40999) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MA 56387) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D40999) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |