| NPI | 1447309281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2009-00667) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL UO1490) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2009-06-24 |