| NPI | 1326186396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD490711) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD37748) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2025-10-28 |