| NPI | 1366470650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 046966) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 046966) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-11-27 |