| NPI | 1033210901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A64211) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A64211) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-06-22 |