| NPI | 1497286603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A161518) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A161518) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-09-18 |