| NPI | 1588770846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301050951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301050951) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2025-07-16 |