| NPI | 1285671529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A96090) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L7666) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-08-28 |