| NPI | 1336338185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD30077) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA05852400) |
| 208000000X Pediatrics (Licence: MD D0046839) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2009-09-02 |