| NPI | 1225120769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI MD-11054) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G84261) |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: HI MD-11054) | |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: CA G84261) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-08 |