| NPI | 1881943090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA MD-49786) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-11469) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2022-07-23 |