| NPI | 1053930230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 84060-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10070696) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2024-08-09 |