| NPI | 1952006710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2024023596) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-12042) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-08-26 |