| NPI | 1093932709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MN 53839) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 53839) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2023-07-14 |