NPI | 1205101714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ND 13948) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IA 40161) |
208000000X Pediatrics (Licence: ND 13948) | |
Enumeration Date | 2012-03-16 |
Last Update Date | 2016-08-31 |