| NPI | 1669406468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G22043) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA g22043) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-03-19 |