| NPI | 1366731283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME125200) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NM MD2014-0220) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.139280) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2022-01-27 |