| NPI | 1699302851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A196986) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0070998) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-09-13 |