| NPI | 1932542669 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.33823)  | 
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL 33829)  | 
| Enumeration Date | 2013-04-11 | 
| Last Update Date | 2024-07-24 |