| NPI | 1033422571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 51791) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 18622) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2019-08-23 |