| NPI | 1841358116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D35124) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-05-1754) |
| 208000000X Pediatrics (Licence: DC 16731) | |
| 208000000X Pediatrics (Licence: VA 0101058626) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2023-10-05 |