| NPI | 1659474666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MT 11725) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AK 4180) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-11-27 |