| NPI | 1841386984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TN 24373) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 24373) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-06-21 |