| NPI | 1316238751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 67495-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT220825) |
| 208000000X Pediatrics (Licence: WI 67495-20) | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2026-06-26 |