NPI | 1306152939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 48945) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125057190) |
Enumeration Date | 2010-08-19 |
Last Update Date | 2021-09-07 |