| NPI | 1831172071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0080153) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD034612E) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-10-29 |