| NPI | 1427243104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A80151) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2007-01732) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2024-01-25 |