| NPI | 1982776068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV 5315) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G54499) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2023-06-04 |