| NPI | 1346818077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA MD-53231) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-12076) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2024-08-14 |