| NPI | 1144614611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: SD 15492) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-45242) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-10-28 |