| NPI | 1457472227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: GA 59178) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 49133) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 49133) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-04-15 |