| NPI | 1740394378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD10368) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G87002) |
| 208000000X Pediatrics (Licence: NM MD2005-0001) | |
| 208000000X Pediatrics (Licence: IN 01055830A) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2011-10-22 |