| NPI | 1326667437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0076422) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 1.075481-DO) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-12-17 |