| NPI | 1467431569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35 04 3249P) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 0102335 IN) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2013-11-26 |