| NPI | 1144291014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: SC 10091) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ND 10782) |
| 208000000X Pediatrics (Licence: ND 10782) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-05-24 |