| NPI | 1427136233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G36418) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G36418) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-03-26 |