| NPI | 1831359389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 061209) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA AN2359001B9331) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2009-05-05 |