| NPI | 1346265477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 3121741205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 3121741205) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2025-09-11 |