| NPI | 1720188188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 230072) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD H0101126) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-07-18 |