| NPI | 1225322456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 56602) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT199142) |
| 208000000X Pediatrics (Licence: NY 276995-1) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 276995-1) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-07-21 |