| NPI | 1124525944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T0603) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2024012062) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KS 04-49099) | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2024-07-01 |