| NPI | 1487709044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 053312) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D44535) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |