| NPI | 1396236287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AZ 70115) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 70115) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2023-08-17 |