| NPI | 1710131529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2017-01979) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 10914) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2022-07-21 |