| NPI | 1558568162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM rs20070321) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 243449) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2010-06-18 |