| NPI | 1679548218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD431024) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C1-0007921) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2015-02-13 |