| NPI | 1841728102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX BP10083187) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 22686) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2023-07-07 |