| NPI | 1083092449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 4302) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2019-02092) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2021-08-27 |