| NPI | 1801895925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD046624L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA BM3176903) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2020-09-16 |