| NPI | 1083906168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI MD17600) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A124771) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2014-05-13 |