| NPI | 1033371216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 47264) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 47264) |
| 208000000X Pediatrics (Licence: MA 236963) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2019-10-17 |