| NPI | 1598185027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 60977) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A149154) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-12-21 |