| NPI | 1629073192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D-05632) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD D-05632) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D-05632) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2023-03-07 |