| NPI | 1073262150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2022021135) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-11025) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-08-07 |