| NPI | 1326060195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MO 2023046668) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KS 04-48700) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2025-11-25 |