| NPI | 1346636800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101261279) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S3315) |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2024-07-11 |