| NPI | 1881930956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A25064) |
| Additional Taxonomies | 2080P0208X Pediatrics Pediatric Infectious Diseases (Licence: CA A25064) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |