| NPI | 1336448901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 249940-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 049844) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 049844) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2021-10-18 |