| NPI | 1336173491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 3883) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 3883) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-10-20 |