| NPI | 1215104864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2011-00473) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2011-00473) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2021-02-22 |