| NPI | 1104823160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 030771) |
| Additional Taxonomies | 2080T0002X Pediatrics, Medical Toxicology (Licence: GA 030771) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2007-07-08 |