| NPI | 1437843356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 325389) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0090215) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-09-13 |