| NPI | 1992816227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 27-0034858) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-46883) |
| 208000000X Pediatrics (Licence: CA A63682) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-04-06 |