| NPI | 1215910435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 032908) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 032908) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-12-29 |