| NPI | 1457320061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 162554) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 162554) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2021-05-14 |