| NPI | 1518291145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 46081) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R71564) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2023-01-21 |