| NPI | 1346238516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC 2982) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0009712) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2007-07-08 |