| NPI | 1124224357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101251806) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101251806) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-04-25 |