| NPI | 1841604089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101021211) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID O-1006) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-06-05 |