| NPI | 1386708006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2002-00217) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2002-00217) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2012-05-30 |