| NPI | 1922175538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01065327A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57-011917) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2012-06-08 |