| NPI | 1386384568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2022022998) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-11045) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-06-27 |