| NPI | 1578505590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0057819) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD D0057819) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-10-21 |