| NPI | 1346351228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 46605) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 46605020) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-02-02 |