| NPI | 1649488925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD432119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-116366) |
| 208000000X Pediatrics (Licence: IL 036-116366) | |
| 207R00000X Internal Medicine (Licence: PA MD432119) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2008-09-26 |