| NPI | 1346627015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD493465) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0092401) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2026-04-21 |