| NPI | 1316905003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.042809) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35042809B) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2014-10-07 |