| NPI | 1932261831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AK AA1356) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AK AA1356) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2023-03-07 |