| NPI | 1841451721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 57663) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.123641) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2022-05-10 |