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 |