| NPI | 1487691598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 23330) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MO 11803) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2023-01-20 |