| NPI | 1497739924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080T0002X Pediatrics, Medical Toxicology (Licence: KY 21334) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 21334) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2014-09-05 |