| NPI | 1144970393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2022020052) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-11139) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-08-02 |