| NPI | 1366490492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX L 8160) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L8160) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-05-07 |