| NPI | 1437218013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 064828) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A61760) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2011-12-05 |