NPI | 1114363728 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 300579) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 300579) |
Enumeration Date | 2013-05-22 |
Last Update Date | 2023-09-13 |