| NPI | 1033418397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101252938) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX U8281) |
| 208000000X Pediatrics (Licence: VA 0101252938) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2025-03-27 |