| NPI | 1093155731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0102204060) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 96658) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2024-02-26 |