| NPI | 1194748616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MN 49118) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 49118) |
| 208000000X Pediatrics (Licence: CA A69283) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-12 |