| NPI | 1144428731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60636444) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101241595) |
| 208000000X Pediatrics (Licence: MD D0069885) | |
| 208000000X Pediatrics (Licence: DC MD038296) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-12-12 |