| NPI | 1447316799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ID M-14706) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N3122) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2024-01-06 |