| NPI | 1548336803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0026218) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101221514) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-11-25 |