| NPI | 1376511907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101029940) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: VA 0101029940) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |