| NPI | 1700948841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD34870) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN7899) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-09-14 |