| NPI | 1396810933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME0070278) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME70278) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2012-07-02 |