| NPI | 1245294271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WV 19640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 19640) |
| 208000000X Pediatrics (Licence: WV 19640) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2021-11-30 |