| NPI | 1497938070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 232329) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C55381) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2020-05-01 |