| NPI | 1013146497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101249820) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: VA 0101249820) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2024-04-03 |