| NPI | 1780838698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101266858) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 119740) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2023-02-20 |