| NPI | 1952600207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P8889) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C199694) |
| 208000000X Pediatrics (Licence: CO CDR.0003804) | |
| 208000000X Pediatrics (Licence: PA MD485861) | |
| 208000000X Pediatrics (Licence: FL ME170402) | |
| 208000000X Pediatrics (Licence: MO 2024043127) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2024-10-29 |