| NPI | 1518938141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 235529) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 235529) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD062854L) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2020-05-29 |