| NPI | 1104489335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX T8334) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA 205746) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 75879) | |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2025-12-02 |