| NPI | 1407851249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX L0292) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX L0292) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2021-04-23 |