| NPI | 1740679315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0087118) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD047026) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2024-01-30 |