| NPI | 1316923352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD08929) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI 8929) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-04-29 |