| NPI | 1528314093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: FL ME132276) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: TN 48738) |
| 208000000X Pediatrics (Licence: TN 48738) | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2021-01-11 |