| NPI | 1033152038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA GFE72019) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G72019) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-10-31 |