| NPI | 1407832751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD222344) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A65278) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2025-04-01 |