| NPI | 1710939780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 26446-20) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: IA 26887) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: WI 26446) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-05-26 |