| NPI | 1013390582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.141502) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 68839-20) |
| 208000000X Pediatrics (Licence: MI 4301107008) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 68839-20) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2021-06-24 |