| NPI | 1093940942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR E-13484) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 54140) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2020-09-28 |