| NPI | 1821076274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD.017838) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 017838) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2017-01-24 |