| NPI | 1770779845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD441601) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD441601) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2021-07-28 |