| NPI | 1922239383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2012-01258) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 003415) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2015-05-12 |