| NPI | 1043673270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD D0099006) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0099006) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MD D0099006) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2024-06-20 |