| NPI | 1386267755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA MD-51248) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-11830) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2024-03-08 |