| NPI | 1871631069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G031517) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA G031517) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA G031517) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-08 |