| NPI | 1538170808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G32682) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G32682) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2010-02-19 |