| NPI | 1275068355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 69284) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35139275) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35139275) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2023-08-29 |