| NPI | 1053385658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101030943) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101-030943) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2024-06-21 |