| NPI | 1982666426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D15927) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D00015927) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2020-10-07 |