| NPI | 1215924451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A60568) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A60568) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2013-11-14 |