| NPI | 1447305594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2007-0686) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD23548) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2013-04-16 |