| NPI | 1528487675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 4734) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 4734) |
| 208000000X Pediatrics (Licence: NY 294597) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-05-15 |