| NPI | 1548252836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M3717) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME155078) |
| 208000000X Pediatrics (Licence: GA 93641) | |
| 208000000X Pediatrics (Licence: AZ 65186) | |
| 208000000X Pediatrics (Licence: CA A88020) | |
| 208000000X Pediatrics (Licence: HI MD-22303) | |
| 208000000X Pediatrics (Licence: MO 2022002034) | |
| 208000000X Pediatrics (Licence: WA MD61238004) | |
| 208000000X Pediatrics (Licence: NV 21793) | |
| 208000000X Pediatrics (Licence: PA MD421935) | |
| 208000000X Pediatrics (Licence: CO DR.0067576) | |
| 208000000X Pediatrics (Licence: MD D95328) | |
| 208000000X Pediatrics (Licence: IL 036158875) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-11-04 |