| NPI | 1497999742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD30363) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 49283) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2026-02-11 |