| NPI | 1295714723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 48863-020) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 43628) |
| 208000000X Pediatrics (Licence: IN 01053869A) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2022-11-17 |