| NPI | 1558528042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 16602) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ AZ16602) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2026-06-03 |