| NPI | 1366685943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: TX S4754) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 765) |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MD H86254) | |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: NE 765) | |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2020-07-28 |