| NPI | 1316042286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME47750) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI DK024810) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2008-12-29 |