| NPI | 1306208434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101266738) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101266738) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-05-14 |