| NPI | 1831304526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 24019) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID M-11679) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2024-04-26 |