| NPI | 1568858199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 72458) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A155154) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MN 80640) | |
| 208000000X Pediatrics (Licence: TX U1062) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX U1062) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2025-09-12 |