| NPI | 1831353937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR E-9348) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-9348) |
| 208000000X Pediatrics (Licence: FL ME111241) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2023-05-03 |