| NPI | 1083771398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C173151) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-095191) |
| 208000000X Pediatrics (Licence: GA 86455) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2022-12-01 |