| NPI | 1184706426 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA G31395)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G31395)  | 
| Enumeration Date | 2006-10-19 | 
| Last Update Date | 2025-09-11 |