| NPI | 1518169499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD431941) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT184547) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2021-07-27 |