| NPI | 1992844930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 41493) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM 2006-0246) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: AZ 41493) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-01-22 |