| NPI | 1174727457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 51286) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57008906) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MN 50389) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2024-04-24 |