| NPI | 1285831636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA MD-42020) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 296011) |
| 208000000X Pediatrics (Licence: IL 036118885) | |
| 208000000X Pediatrics (Licence: IN 01082130A) | |
| 208000000X Pediatrics (Licence: FL ME138768) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-11-11 |