| NPI | 1376854653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301109063) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2010021892) |
| 208000000X Pediatrics (Licence: MI 4301109063) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2019-11-21 |