| NPI | 1073584231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME120573) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.024437) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2022-07-21 |