| NPI | 1336198548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2013-01825) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A49616) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2022-03-17 |