| NPI | 1053491902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: WV 20855) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: WV 20855) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2022-04-07 |