| NPI | 1386705721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101057696) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D61216) |
| 208000000X Pediatrics (Licence: DC MD034757) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-06-23 |