| NPI | 1932299435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR N-7829) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AR N-7829) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: AR N-7829) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-31 |