NPI | 1285612119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME81290) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 219864) |
2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 219864) | |
Enumeration Date | 2005-12-30 |
Last Update Date | 2022-02-14 |