| NPI | 1184989436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 22495) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.061701) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2015016128) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2022-12-05 |