| NPI | 1518305127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD458942) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT203920) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2019-05-06 |