| NPI | 1255564266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA C196345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C196345) |
| 208000000X Pediatrics (Licence: NY 255256) | |
| 208000000X Pediatrics (Licence: PA MD442411) | |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2024-10-11 |