| NPI | 1093873309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A70850) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI MD-13540) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2021-11-22 |