| NPI | 1437250917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL MD90893) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME90893) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2021-06-07 |