| NPI | 1477181402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0073251) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.46984) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-06-14 |