| NPI | 1699785691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0037143) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 37143) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-01-09 |