| NPI | 1689251068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0100803) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD 7816) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2025-07-15 |