| NPI | 1598057333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A122799) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A122799) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2016-08-02 |