| NPI | 1942620992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0089648) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0089648) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2022-06-24 |