| NPI | 1497829592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0040023) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD10045) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2013-02-27 |