| NPI | 1104875582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2017-00337) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2017-00337) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: DC MD210002754) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101262031) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-08-13 |