| NPI | 1427378561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 16276) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-14613) |
| 208000000X Pediatrics (Licence: TX Q3380) | |
| 208000000X Pediatrics (Licence: OK 5994) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2021-10-30 |