| NPI | 1356576649 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2015-02428) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2015-02428) | 
| Enumeration Date | 2009-05-15 | 
| Last Update Date | 2024-07-15 |