| NPI | 1487184297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.150892) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301112632) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-09-13 |