| NPI | 1316239064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101261501) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 60709) |
| 208000000X Pediatrics (Licence: VA 0101261501) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN MD52574) | |
| 208000000X Pediatrics (Licence: NY 311591) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD463502) | |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2026-03-31 |