| NPI | 1063940054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101265794) |
| Additional Taxonomies | 2080S0012X Pediatrics, Sleep Medicine (Licence: VA 0101265794) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2022-06-21 |