| NPI | 1861470262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME138229) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 36305) |
| 208000000X Pediatrics (Licence: IL 036107318) | |
| 208000000X Pediatrics (Licence: IN 01078965A) | |
| 208000000X Pediatrics (Licence: MO 115222) | |
| 208000000X Pediatrics (Licence: PA MD445768) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2023-08-08 |