| NPI | 1295816106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 0000-36129) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 36129) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2025-04-30 |