| NPI | 1912976150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 51881) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: FL ME74080) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2014-10-07 |