| NPI | 1063443711 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AR E-16475) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2008008121) |
| 208000000X Pediatrics (Licence: MO 2008008121) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2008008121) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KS 05-35685) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-04-19 |