| NPI | 1982680575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 33948) |
| Additional Taxonomies | 2080T0002X Pediatrics, Medical Toxicology (Licence: MA 33948) |
| 208M00000X Hospitalist (Licence: MA 33948) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2007-07-08 |