| NPI | 1881824191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD451777) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 250822) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2018-12-03 |