| NPI | 1871168294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD484351) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT222486) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-04-22 |