| NPI | 1841232360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 74058) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301086489) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2023-08-21 |