| NPI | 1497747364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101248066) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0062711) |
| 208000000X Pediatrics (Licence: DC MD040935) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2021-06-01 |