| NPI | 1265895692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101268482) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0096941) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2023-04-16 |