| NPI | 1144236399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 35767) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C35767) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-07-13 |