| NPI | 1982431383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL HSE41403) |
| Additional Taxonomies | 174H00000X Health Educator |
| 174N00000X Lactation Consultant, Non-RN | |
| 2471S1302X Radiologic Technologist, Sonography (Licence: P10710) | |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2025-05-16 |