| NPI | 1619989407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0026274) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD D26274) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2026-02-19 |