| NPI | 1992746143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 27048) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NC 27048) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-05-10 |