| NPI | 1356978183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS023514C) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS023514C) |
| 208000000X Pediatrics (Licence: IN 02008753A) | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2025-12-02 |