| NPI | 1851598544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C55538) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0066190) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-05-03 |