| NPI | 1295350072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NE 35880) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 8730) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2025-11-24 |