| NPI | 1427032556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0052965) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 74085) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2013-09-22 |