| NPI | 1558303461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC MD043162) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0063408) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-03-17 |