| NPI | 1427631274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0069981) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI DOSR-535) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2025-07-23 |