| NPI | 1013229988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME143158) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125058937) |
| 208000000X Pediatrics (Licence: LA 343501) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2024-09-10 |