| NPI | 1376656751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MT MED-PHYS-LIC-19499) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 200751) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2022-02-21 |