| NPI | 1437207024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 225000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 040344) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |