| NPI | 1508870981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: TN 38451) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 38451) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-02-15 |