| NPI | 1427336619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD452384) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI l1983117) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2014-07-08 |