| NPI | 1326158106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL 37785) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 35870) |
| 208000000X Pediatrics (Licence: IL 036-116327) | |
| 208000000X Pediatrics (Licence: MO 18678) | |
| 208000000X Pediatrics (Licence: CO 42247) | |
| 208000000X Pediatrics (Licence: LA 025542) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-07-30 |