| NPI | 1285950469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD456983) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 23965) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WV 23965) | |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2020-10-07 |