| NPI | 1740574425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD16403) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 27871) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2024-06-20 |