| NPI | 1386616431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ID M9890) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 20376) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2024-03-14 |