| NPI | 1295900629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2021-03413) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NC 2021-03413) |
| Enumeration Date | 2008-04-27 |
| Last Update Date | 2024-11-25 |