| NPI | 1366709545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2016-01447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2016-01447) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2023-06-16 |