| NPI | 1215955109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD150434) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A79783) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2009-11-04 |