| NPI | 1548766116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD480019) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD049178) |
| 208000000X Pediatrics (Licence: MD D95565) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2023-03-09 |