| NPI | 1376476341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G42945) |
| Additional Taxonomies | 261QR1100X Clinic/Center, Research (Licence: CA G42945) |
| Enumeration Date | 2026-06-08 |
| Last Update Date | 2026-06-08 |