| NPI | 1699383927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DE C1-0026913) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT221857) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2024-06-25 |