| NPI | 1427045038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD23567) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS MD13478) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2016-07-13 |