| NPI | 1366518342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A44860) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A44860) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2013-05-23 |