| NPI | 1497799670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ID M-9122) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID M9122) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-06-04 |