| NPI | 1427493394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A147193) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD044341) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2018-07-16 |