| NPI | 1124027123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2023-00091) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA MD.13478R) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2024-06-06 |