| NPI | 1154371961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA 333543) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WA MD60860139) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-04-17 |