| NPI | 1144221763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA a72066) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A72066) |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2011-02-01 |