| NPI | 1699792408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME77338) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME73660) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2011-11-02 |