| NPI | 1134252463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME39365) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME39365) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2024-03-26 |