| NPI | 1538582911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301111535) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ND 13126) |
| 208000000X Pediatrics (Licence: VA 0101250734) | |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2022-07-21 |