| NPI | 1013979814 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA G69024)  | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 28540)  | 
| Enumeration Date | 2006-04-05 | 
| Last Update Date | 2023-11-08 |