| NPI | 1497844682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101222261) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101222261) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-04-04 |