| NPI | 1891814638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D69978) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A95935) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-01-26 |