| NPI | 1295750842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0046613) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD12072) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-08-15 |