| NPI | 1437170776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 18546) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 9601273) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2016-12-30 |